Use of azithromycin for the treatment of campylobacter enteritis in travelers to Thailand, an area where ciprofloxacin resistance is prevalent

Robert A. Kuschner, Andrew F. Trofa, Richard J. Thomas, Charles W. Hoge, Chittima Pitarangsi, Steven Amato, Raymond P. Olafson, Peter Echeverria, Jerald C. Sadoff, David N. Taylor

Research output: Contribution to journalArticlepeer-review

Abstract

We evaluated the use of azithromycin (500 mg) or ciprofloxacin (500 mg) daily for 3 days forthe treatment of acute diarrhea among United States military personnel in Thailand. Stool cultures were obtained and symptoms were recorded on study days 0, 1, 2, 3, and 10. Campylobacter species were the most common pathogen isolated (44 isolates from 42 patients). All Campylobacter isolates were susceptible to azithromycin; 22 were resistant to ciprofloxacin. Among the 42 patients with campylobacterinfection, there were 2 clinical and 6 bacteriologic treatment failures in the ciprofloxacin group and no treatment failures in the azithromycin group (P =.021 for bacteriologic failures). Overall, azithromycin was as effective as ciprofloxacin in decreasing the duration of illness (36.9 hours vs. 38.2 hours, respectively) and the number of stools (6.4 vs. 7.8, respectively). Among those not infectedwith Campylobacter species (n = 30), the duration of illness was 32.9 hours vs. 20.7 hours (P =.03) for the azithromycin and ciprofloxacin groups, respectively. Azithromycin is superior to ciprofloxacin in decreasing the excretion of Campylobacter species and as effective as ciprofloxacin in shortening the duration of illness. Azithromycin therapy may be an effective alternative to ciprofloxacin therapy in areas where ciprofloxacin-resistant Campylobacter species are prevalent.

Original languageEnglish (US)
Pages (from-to)536-541
Number of pages6
JournalClinical Infectious Diseases
Volume21
Issue number3
DOIs
StatePublished - Sep 1995

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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